Healthcare Provider Details

I. General information

NPI: 1184755670
Provider Name (Legal Business Name): JANELLE E ARIAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 01/21/2020
Certification Date: 01/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6627 W BROAD ST STE 400
RICHMOND VA
23230-1733
US

IV. Provider business mailing address

4525 N RAVENSWOOD AVE STE 201
CHICAGO IL
60640-5201
US

V. Phone/Fax

Practice location:
  • Phone: 804-774-4550
  • Fax:
Mailing address:
  • Phone: 312-878-4520
  • Fax: 708-575-8311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number0101264861
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: